Setting Up Patient Tables and Codes > Diagnosis Codes
Beginning in version 8.11, the WinOMS software uses the ICD-10 diagnosis (Dx) code set, replacing the ICD-9 codes. WinOMS provides new ICD-10 codes as they are updated annually.
The ICD-10 codes are installed to your
database when you update to the new version.
The existing ICD-9 codes are not deleted, and are still valid for the procedures
and claims for which they were used.
The ICD-10 Code set contains more diagnosis
codes than the ICD-9 code set.
In some cases, the codes and their descriptions are longer.
Throughout the software, entry and display fields for diagnosis codes have been expanded.
Hovering tool tips have been added to display the full description when you hold the cursor over a diagnosis code.
A version column has been added to lists to enable sorting by version.
Version controls ensure that only one diagnosis code set is used on any one claim, visit, or treatment plan.
A Frequently Used filter has been added to assist in managing the larger number of diagnosis codes.
The default ICD code version is set at the practice level, but can be changed as needed when selecting codes in other places in the software.
To set the default ICD code set:
Select Tables > Practice > Practice Preferences > Insurance.
Under Miscellaneous > Default ICD Version, select ICD-10.
For more information, see Setting Up Default Insurance Information.
Use the Extended tab of the Patient Data Entry window to enter up to four diagnosis codes for a patient.
The diagnosis code fields have been expanded to accommodate the length of the ICD-10 codes and descriptions.
The diagnosis codes entered here must all be from the same ICD version.
If you need to change the code from another window, such as Charge Entry, select Edit Dx.
For more information, see Adding Patient Information to the Extended Tab.
The Diagnosis Method setting on the Forms/IDs/Notes tab of the Plan Data Entry window now has a third option for defining how diagnosis codes are displayed on claim forms for a particular plan. You can select 3 to include no diagnosis codes or pointers on the form.
For more information, see Adding Forms, IDs, and Notes.
The Diagnosis Code Search window has been updated to accommodate the ICD code set migration.
New column shows the ICD version of each code.
New Version list enables you to filter search by ICD code set.
New checkbox enables you to filter search by Frequently Used codes.
Tool tips display full description when the cursor hovers over a diagnosis code.
Selecting Display All for all versions displays all Dx codes from both versions.
Inactive codes are displayed in gray.
The Diagnosis Code Data Entry window has been updated to accommodate the ICD code set migration.
For adding a new diagnosis code, the Version list defaults to the version entered in practice preferences.
When adding a new ICD-10 code, use the new Lookup button to validate the new code against the ICD-10 list.
For editing, the Version list specifies the code set for the code being edited.
A new checkbox enables you to designate a code as Frequently Used.
For more information, see Diagnosis Codes.
The Diagnosis Code Selection window has been updated to manage the use of old and new ICD codes. Diagnosis codes for any visit or claim must belong to the same code set version.
This window is displayed when you select Dx Codes or Edit Dx when creating or editing treatment plans or patient charges.
Dx codes are displayed for only the selected version.
A Frequently Used filter option has been added.
The Select Dx Code input field has been expanded to accommodate the full code length.
Tool tips display full description when the cursor hovers over a code.
The Diagnosis Codes and For this Charge lists have been expanded to display the full code and longer descriptions.
Dx code lists can be sorted by Dx or Description.
When this window is opened to select the first code for a visit, the practice default ICD version is displayed.
When a different version is selected, it will become the default for this visit.
Once a Dx code
has been selected, the Version
list is locked to prevent mixing versions on a claim.
To change the version, drag the codes from the For this Charge list
to the trash bin. This unlocks the Version list so you can select
a different ICD version and use those codes for the charge.
When editing a batch, you can change the ICD code version for a claim, but only if all procedures from that claim are selected.
When some, but not all, procedures for a claim are batch edited, and the ICD version is changed, the procedures being edited are moved to a new claim with the new ICD codes.
The total number of ICD codes allowed on a single claim has been expanded to 12, but ICD-9 and ICD-10 codes cannot both be present on a single claim at the same time.
Up to four Dx codes are allowed per procedure.
When claims are created, ICD-9 procedures are automatically grouped in a separate claim from ICD-10 procedures.
When the total number of diagnosis codes exceeds 12, a second claim is created.
The Dx Order button has been removed from the Charge Entry and Charge Edit windows. Click Edit Dx on these windows to display the Diagnosis Code Selection window. Use this feature to add or remove codes from the charge, and drag them to the correct order.
For more information, see Editing a Diagnosis on a Charge.
The total number of ICD codes allowed on a single claim has been expanded to 12, but ICD-9 and ICD-10 codes cannot both be present on a single claim at the same time.
When the claim authorizations are created, ICD-9 procedures are automatically grouped in a separate authorization from ICD-10 procedures.
When the total number of diagnosis codes exceeds 12, a second claim is created.
New windows enable you to view the diagnosis codes assigned to the procedures in a patient's treatment plan.
From the Treatment Plan tab of the Patient Workspace or Point-of-Care Encounter window, click the Details button. The View Treatment Plan Details window is displayed for the selected plan.
This window lists procedures and the associated Dx codes, regardless of whether they have been performed or converted to charges. It cannot be edited. To edit Dx codes for a procedure, return to the Treatment Plan window.
For more information, see Creating a Plan for Treatment Visits.
The new Claims Modification window enables you to adjust the order of diagnosis codes on a claim (box 21 for medical and box 34a for dental) after charges have been posted, before you submit the claim. The codes are labeled A through L, with A being the primary diagnosis.
The Dx Order is also displayed on the Claim Detail window accessed by clicking Details in the Insurance Processing Queue.
Previously, the Dx Order button was only available from the Charge Entry and Charge Edit windows at the time of posting.
To access the new Dx Ordering feature:
From the Patient Workspace, select the Claims tab.
Select a claim and click Edit. The Claims Modification window is displayed.
Under Dx Rank, click and drag the codes to reorder them.
For more information, see Editing a Claim.
Because ICD-9 and ICD-10 codes cannot be mixed on a single claim, the process for posting and editing procedures has been updated to correctly group ICD codes by version.
When the total number of diagnosis codes exceeds 12, a second claim is created.
Forms 110 and 111 have been expanded to handle ICD-10 codes. Box 34 shows the correct identifier based on the version being used:
B - ICD-9
AB - ICD-10
Forms 110 and 111 use only the first four codes, which are highlighted on the Claim Modification window. Any diagnosis codes beyond the first four are dropped from the claim.
Pointer information in box 29a is based on the codes that appear in box 34a.
Forms 112 and 113 have been expanded to handle ICD-10 codes. Box 21 shows the correct identifier based on the version being used:
9 - ICD-9
10 - ICD-10
Box 21 shows up to 12 diagnosis codes. Pointers in box 24E reflect the correct codes from box 21.